Interoperability: Counting Transactions is Not the Answer - Cover

Interoperability: Counting Transactions is Not the Answer

When vendor CEOs challenged KLAS to find a way to deeply measure interoperability, it seemed an impossible task. Even though KLAS has bright people, a deeper industry measurement needed serious expert guidance and oversightùa gap for KLAS.

The best industry minds were needed to help define and build a measurement tool. How? KLAS' Advisory Board recommended using an expert panel or committee to see whether a useful measurement tool was possible and then actually help build the tool. Dozens of possible participants (passionate, smart, and seasoned) needed to be narrowed down to four. A larger number seemed untenable, and a smaller number seemed too prone to bias. A prudent mix would include the following:

  • A detail-oriented patriarch full of wisdom and gentleness: Stan Huff, MD, Intermountain, HL7, HSPC+
  • A no-holds-barred paradigm-breaker: John Halamka, MD, Beth Israel Deaconess & Harvard CIO
  • A practical day-to-day warrior: Daniel Nigrin, MD, Boston Children's CIO
  • A well-known leader in the cross hairs: Micki Tripathi, Massachusetts eHealth Collaborative CEO

Taylor Davis, KLAS' catalytic personality, hosted the group, and the deepest thoughts initially lead to divergent solutions. One that was taken off of the table right away was counting interoperability transactions. Counting transactions would prove useful but not key. After much time and effort, a measurement tool appeared elusive. Suddenly, a light came on among the four, and they coalesced around a path to success that all agreed would work: viewing interoperability through the eyes of clinicians using these systems. It was worth presenting to vendor CEOs and their most engaged executives at the Keystone Summit along with 32 provider executives to see whether the group could transform it into the questionnaire for a 2016 test run. All 12 vendors in attendance confirmed that the recommended changes resulted in a viable measurement tool.

KLAS tagged these brave volunteers the fantastic four with good reason. They found a way to build a measurement tool while looking at it from different vantage points. Payment for their services was not in dollars but in accelerated interoperability success. Interestingly, not everyone was 100% happy with the individuals, and proposed that these four might be too mired in the semantic world, too narrow in regards to real experience, too biased in their thinking, or too extreme or disruptive in their solutions. From my perspective and based on the things I heard from those who attended the KLAS Keystone Summit, they were miracle makers and really deserve the label of the fantastic four.

RESULTS: KLAS has done a test run of the tool and will launch the study shortly. Those that want to participate should please contact Bob Cash at

Follow-up blogs will provide more details about the 2015 Interoperability Study and the Keystone Summit.



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